Northlake Physician Practice Network Inc

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

Legal business name

NORTHLAKE PHYSICIAN PRACTICE NETWORK INC

Practice address

1459 Montreal Rd
408
Tucker, GA 30084-6900

Phone

(770) 938-3440

Fax

(770) 938-3443

NPI assigned

Jun 3, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Pickett

Title

VP

Phone

(678) 762-5037

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raymond A Lawhead Jr., MD

  • Gynecologic Oncology Physician
  • Decatur, GA
  • NPI 1922093350
  NPD (past)
• Elizabeth P Rambo, PA-C

  • Physician Assistant
  • Austell, GA
  • NPI 1912991464
  NPD (past)
• Sarah L Hosford, MD

  • Gynecologic Oncology Physician
  • Lubbock, TX
  • NPI 1710982277
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285672220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1459 MONTREAL RD",
            "address_2": "408",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846900",
            "telephone_number": "770-938-3440",
            "fax_number": "770-938-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 MONTREAL RD",
            "address_2": "408",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846900",
            "telephone_number": "770-938-3440",
            "fax_number": "770-938-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAKE PHYSICIAN PRACTICE NETWORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PICKETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "678-762-5037"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northlake Medical Center, LLC (Northlake Medical Center)
• Northlake Medical Center, LLC (Northlake Medical Center)
• Northlake Medical Center, LLC (Northlake Medical Center)
• Northlake Medical Center, LLC (Northlake Medical Center)
• Northlake Multispecialty Associates LLC
• Northlake Physician Practice Network, Inc. (Women's Cancer Alliance)
• Northlake Urgent Care Inc
• Northlake Women's Specialists
• Northland Hearing Centers, Inc (NuEar Hearing Center)
• Now: New Opportunities Waiting

• Surgical Oncology Physician in Tucker, GA
• Providers in Tucker, GA by specialty
• Surgical Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.